Hepatitis B Boosters Using a Different Product vs. the Same Product for Kidney Transplant Recipients: A Retrospective...

Area of Science:

• Immunology
• Transplantation Medicine
• Vaccinology

Background:

• Hepatitis B vaccination is crucial for kidney transplant recipients (KTR) to prevent infection.
• Suboptimal antibody responses to hepatitis B vaccines necessitate further investigation into booster strategies.
• The effectiveness of using a different vaccine product as a booster in non-responding KTR remains unevaluated.

Purpose of the Study:

• To evaluate the effectiveness of a hepatitis B vaccine booster strategy using a different product compared to the same product in kidney transplant recipients with inadequate antibody titers.
• To determine the seroconversion rate (hepatitis B surface antibody level ≥ 10 IU/mL) in non-responding KTR after booster vaccination.

Main Methods:

• A comparative study involving kidney transplant recipients who did not achieve adequate antibody titers after primary hepatitis B vaccination.
• Patients received either a booster dose of the same vaccine product or a different vaccine product.
• Seroconversion rates were assessed as the primary outcome.

Main Results:

• Overall, only 19.2% of non-responders achieved seroconversion after booster doses.
• The crossover group (different product) showed a 20% seroconversion rate, while the non-crossover group (same product) had an 18.2% rate (p=1.0).
• Bayesian analysis indicated a posterior probability of 23% for the crossover group versus 14% for the non-crossover group, with overlapping credible intervals.

Conclusions:

• Switching hepatitis B vaccine products as a booster strategy did not significantly enhance seroconversion rates in kidney transplant recipients.
• The current crossover strategy is not demonstrably superior to using the same vaccine product for boosting immunity.
• Alternative approaches are required to improve hepatitis B protection in KTR who are initially non-responsive to vaccination.